The aim in establishing a Clinical Oncology Program at Geisinger Medical Center is to channel a large number of patients with cancer into quality research treatment protocols, taking full advantage of the tertiary nature of the center (accrues rare cancers and is able to provide state-of-the-art care and facilities). Aspects of the Geisinger system that are advantageous include its large cancer patient population (1400 new pts/yr.), its excellent medical record system with unit patient charts, the presence of all needed treatment facilities and specialists under one roof, with an organized cancer center in place, and its past record of proven commitment to clinical research and capabilities to manage protocol data effectively. All of the headquarters and data management staff required for successful CCOPS operation are already in place, all doing their planned functions. The nature of the planned research participation is multimodal, as well as multidisciplinary. Our CCOPS will feature a multidisciplinary group--the Mid Atlantic Oncology Program--as its primary base with specialty bases to include a radiation therapy group--The RTOG--, as well as a pediatric base--the Children's Cancer Study Group. We feel this multifaceted selection of research bases definitely enhances multimodality cooperation here within the CCOPS, as well as providing an unusual balance for a community program. The referral area of the Geisinger Medical Center is such that changes in care here have a ripple effect throughout a wide area. The medical center is the recognized care leader in this part of Pennsylvania, having been designated one of only four tertiary care centers for the entire state. As the application will make clear, we have also felt the responsibility to play a leadership role in education, cancer control and administrative assistance to the various community hospitals to which we relate. Geisinger has grown into a system of health care in recent years, now owning and operating a new large hospital in the Wilkes-Barre-Scranton area, running a multispecialty medical group in the same area, owning another multispecialty group 100 miles to our west, owning and operating ER's and other facilities in the region. The beneficial effect of a CCOPS in such a system will cover a large area.